Hello. I have posted before about being overweight with AF and the fact that I am too heavy for an ablation.
I have been on a weight loss pathway with the nhs for 5 years culminating in weight loss surgery booked for yesterday. The surgery organisers had spoken to my cardiologist and confirmed that even though my AF bpm is 120-140, I am haemodynamically stable and I was authorised to go ahead. I have had many different opinions on the high heart rate but even 4 weeks ago in an and e I was told it was fine. I also have breathing difficulties on occasion and had to go to an and e recently. I was told it was intestinal colic or possibly reaction to bisoprolol.
Anyway yesterday I was at the hospital at 7, by 12 I was in my gown waiting for surgery and the anaesthetist came to see me and said he wouldn’t go ahead because my af was far too unstable. I am so upset. I think the thing about weight loss surgery is that you are psychologically primed to have it (so that you don’t back out of the program and because it is difficult) so you re- envision your life. It gave me a lot of hope for the future. When I spoke to the organisers, they said realistically an anaesthetist is going to continue to refuse me.
I don’t understand why my EP, arrhythmia nurse, Aand E and GP all say that I am stable?
I am frightened by the breathing episodes because they are random. Yesterday I had one whilst walking to the hospital bedroom - but then at home I ran up two sets of stairs. Since yesterday I have been very stressed and my af is uncomfortable. I can’t see a way out of this.
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Rhiannonimity1
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I am so sorry for you. Anaesthetists do have the last word though as your life is in their hands. You are doing all you can . Would this new weight loss injection work for you? I imagine you have looked into this.
Thank you Jalia. Do you mean Wegovy - unfortunately a side effect of most of these tablets is a speedier heart rate which is no good for me sadly. Someone has just mentioned gastric balloon. A swallowable balloon might be worth a try.
lm so sorry that this has happened to you. The anaesthetist ultimately runs the show with regard to your safety and if he’s happy to proceed. Could you change from bisoprolol to something else, I found it made me gain a stone very quickly and nearly impossible to loss.
So can you try a very short term pre surgery diet? Get everything in good shape? I’ve had 2 weight loss surgeries- Gastric Sleeve pre AF and a revision to Gastric bypass when I had AF.
Of course pre surgery strict diets are hard but the benefits are great. Better health and of course a new look.
Hello. I did the pre surgery diet over two weeks and lost nearly a stone. Very fatigued though. The drs told me that I am unlikely to get a new date because in their eyes my AF is too fast for surgery. I have been on this road for 4 years, travelling hundreds of miles for appointments, jumping through the hoops and at the very last minute - they won’t do it. I think the worst thing, as you will know Gabriel is that they build you up to imagine your life as a thinner person. All the things you can do, the places you can go. This is in the months before surgery and is to prevent you from backing out. Then they cancel and leave you completely shattered and without hope.
They don't appear to be able to. My slim , fit sister (she walked everywhere because she would not drive after she hit a badger one night) was sent home from hospital after she was sent home after being admitted for a Gall Bladder operation, because they could not get her heart rate down, She never had the op.
Very sorry for your sister but if your heart rate is up and you are big, no matter what they will blame the weight. If bariatric surgery isn’t an option for this person …. Then sadly weight loss by diet and will power is still needed. Hard and very difficult but that appears to be the only way. Not saying it’s right but it seems the harsh reality.
Hi Gabriel. Sorry for the misunderstanding - it is me- not my sister. I rambled a bit in my last post. It is a harsh truth, but you are no doubt correct.
Yes I knew that -I was referring to the other poster’s sister. However I was referring to you about the horrible way you get treated when overweight… I don’t even like that word tbh ….
Whatever the ailment - weight comes up. Even with a cold. Makes me cross.
Me too. Angry but also ashamed and frightened to make a fuss. I think it is the assumption that you sit watching tv , eating biscuits all day - which for the overweight people I know couldn’t be further from the truth.
Curious what is a "Stone".....??? Must be UK for something....??? Over here we have Kidney Stones that we loose...but not sure that's what you mean here
I'd be delighted to hit 13 stone — that's been my best weight in the past. But realistically, with knees, back, shoulders, and metabolism shot, I'd be over the moon to make it back to 17.
Current goal is to get light enough to get my knee replacement ... but vigorous exercise has always been my best bet for staying slim, and I'm so broken, and so breathless after Covid, it's hard to do much.
A low carb diet does help me — protein and low-carb veg, like tonight's steamed salmon with stir-steamed leeks and bok choi 🥬 — but we're already eating that way.
So sorry, I can only try to imagine how disappointing that must have been……I took bisoprolol for a few days recently, ended up having an episode where I felt as if I had swallowed something that stuck in my throat and had to take four doses of my inhaler in quick succession - was promptly taken off it! I know you have been all round the houses with medication so won’t make ‘helpful suggestions’ but I know that most meds intended to slow heart rate also seem to cause weight gain in many people so you are in a bit of a spiral.
Yes Buffafly. You are 100% right about the slowing of the heart rate.I'm on Bisoporil 7.5mgs, amongst many other medications and I swear my metabolism has gone into reverse.
I can bearly lose a single LB !
It's soul destroying- all that effort for zero results. At 62, I've pretty much given up . .
Bisopropol because it slows the heart rate slows the metabolism. My cardiologist was insistent on me losing weight but the bisopropol and then sotalol scuppered that. Second opinion and he approved me for an ablation. Nsr since last Dec. Working on weight now with slimming world. Would it be possible to ask if a calcium channel blocker would do what bisopropol does? Also that's a big dose, I couldn't tolerate 1.25mg bisopropol. So sorry they cancelled your op. Losing weight is difficult at the best of times and you definitely need energy for the food prep.
Hi Mary. I'm not sure if you were intending to reply to me, or the OR (original poster). Only querying this as I'm not waiting for an Ablation or any kind of surgery, thankfully.🌸🌸🌸
I hesitate to mention this but it might change your life…have seen so many unbelievable changes in so many…and really happy people…look up carnivore life style. I think you might be thrilled and healthy. Apologize if this is too personal.
I can well imagine how you feel, your disappointment and feeling of being let down, especially considering what you have probably already achieved weight loss wise during this programme is tangible, and as someone who has also had a weight problem most of their life having first lost 5 stone with Weight Watchers and 30 odd years later another 5 stone with Slimming World! Each time within two years I have put it back on! the really important thing now is to get around this disappointment, in other words keep a positive mind rather than despair because that won't help you now. I am guessing the anaesthetist was anxious as to how your body would react to anaesthetic and complicated surgery, it is their job and responsibility to keep you safe during what would be a complicated and possibly long procedure, however the way I see it, the risks from the conditions you are suffering from may well outweigh the risk of surgery so if you really want to go ahead with this then you may well have to fight for it. Go back to the team who recommended the surgery in the first place, you have spent 5 years with this programme therefore they know you are serious. The fight will keep you going, don't go back to old ways feeling sorry for yourself, if you are determined to deal with this once and for all then go put your case. Sending you giant hugggs at this difficult time but please persevere, there are other anaesthetists and you might just find one who is well practised in dealing with cases such as yours, your cardio will advise. Good luck x
Hi Rhiannonimity1. I was wondering if you could discuss with your cardiologist the possibility of an alternative to Bisoprolol as I was sure this thwarted my attempts at trying to control my weight. I was given Bisoprolol to control my blood pressure. No true diagnosis of AF at the time but the Registrar prescribed a beta blocker mainly to lower my blood pressure because other BP medications weren’t working. I had no other tests at this time. I persevered with the Bisoprolol for almost 3 years but suffered lethargy, shortness of breath, diarrhoea and despite the diarrhoea, my weight ballooned by 3 stones in those 3 years. I also had heart flutters and rapid heartbeats usually when in bed which I naively thought was due to my BP. Finally another GP listened to me. I was taken off the Bisoprolol slowly and it was substituted with Adizem to control my BP. I started a regime of healthy eating and walking daily. I started to lose weight very slowly in fact it has taken 3 years to lose 3 stone and I am continuing my healthy eating and daily walks to help maintain this weight loss. I have now been diagnosed with A F too and I take Edoxaban as well as the Adizem. It was an uphill struggle for me trying to maintain a healthy weight when on Beta blockers although others have no problems at all. Have the conversation and see how it goes but don’t stop taking them without consulting your cardiologist.
I haven't had your experience but I can empathise with the feeling of nowhere to go. Don't give up. I agree it's worth trying a different medication- one that doesn't slow down your metabolism in the way that Bisoprolol does.
What are your options for ablation under sedation? Have they said no to this altogether at present? Or is the weight loss surgery your priority? Seems like you need a coordinated approach to help you get on track. Do you have a good GP you can discuss this with who'd encourage the different entities to work together and come up with a plan?
BTW I have two FB pals in the US - both male - who are on the new wonder drug (can't remember its name) and they're both really pleased.
i am too heavy for ablation. My EP won’t do it unless my bmi is below 35 and says I don’t really have options to lower my heart rate. The bariatric people say my hr too high. I’m in a bind.
I would like to suggest Ozempic to lose weight Just because some people may have a heart rate increase with it MOST DONT. So that’s my advice. It has helped me to loose 40 pounds so far and yes I suffer w parasox afib. Had it both PRIOR and during the Ozempic. FWIW. I just had a AV node ablation and bi Ventricular Pacemaker inserted Monday. All that to allow me to live a better life - wishing u the best.
Hi Bobby. Thankyou. I don’t think Ozempic is available. Wegovy is, but I have no chance of being given that. I am not diabetic or prediabetic. It’s crazy really, because I have complex food allergies, the nhs dieticians refused me saying I was too complex to deal with in a 30 min appointment. I was referred to the bariatric pathway for extra diet help which was then denied because there is no funding in my area. So I got approved for weight loss surgery over 3 years without having seen a dietician or having any help to lose weight. Once you are on the bariatric pathway you have to maintain your weight, not lose or gain in order to proceed. It is madness.
In Canada you can get ozempic if your BMI is over 35. It’s an amazing drug for weight loss I have had friends who have had great success on it. I would really look into it. It’s supposed to be as effective as bariatric surgery. Good luck!
Definitely ask about something other than Bisoprolol. I don't know about slowing the metabolism but I could barely breathe with it.I lost over 4 stone with WW, without exercising initially and then only walking.
You mentioned that you "ran up 2 sets of stairs" so is it worth trying a Slimming group (for accountability) and some exercise if you're able to run upstairs?
Is there a medical reason for your not losing weight? If its psychological, have you tried counselling or hypnotherapy?
Disappointing as it is, the anaesthetist is the expert and has your safety and wellbeing at heart. I know someone suggested you fight for it but I'd say you were better asking if the cardiology, bariatric team and anaesthetist could talk to each other to establish whether you are fit enough or not.
I have gallstones and they won't entertain the idea of doing anything as I'm on the list for a mitral valve repair. I'm happy to go with that as I accept its too risky to do one before the other, much as I may get episodes of agony.
I hope you can get help but definitely mention changing from Bisoprolol to your GP in the meantime.
Thankyou for taking the time for such a detailed reply. I’m trying to get my head round it all and this group is really helping me - so thank you one and all. In answer to your question Ducky I have an adipose disease called lipoedema which is basically a different sort of fat cell not caused by eating or lost through diet which settles on your bum legs and upper arms and gets worse dur8ng puberty, pregnancy and menopause. I am 20 stone in weight of which 4-6 stone might be the lipoedema. The rest is good old- fashioned obesity.
I have a friend with that condition but not to the same extent as yourself. Will the weight loss surgery only impact on your non lipoedema weight then?
Push for all departments to put their heads together on this one. Sometimes, with the NHS, it's best not to assume that they will do the obvious thing of liaising with all interested parties.
And again, have a chat about the Bisoprolol as that may make a difference changing that to another med, which may at least help whilst the rest gets sorted.
Thanks Ducky. The jury is out as to whether bariatric surgery helps with lipoedema. The weight loss people say yes, although the lipoedema weight will be lost last and in the meanwhile it might be quite disabling . The lipoedema people say it doesn’t work at all,don’t do it.
I am so sorry for your predicament. You must be very disappointed. Is there a medical reason for your weight problem? Surely the best thing that you can do is to take several deep breaths and decide that from now on you will have no sugars, and read all packets and shun any that have lots of unpronounceable ingredients as well as corn syrup, and fructose etc and shun simple carbohydrates which the body treats the same as sugars. I have been doing this for years now. Lots of fruit and veg is supposed to be very healthy. Don’t forget to drink lots of water. Good luck.
How disappointing - my heart goes out to you. It would have helped if you at least could have know about this before being all mentally and physically prepared! Our public services are constantly bleating on about 'joined up thinking' but as far as I can see there's zero going on.
So, I only have a question. If your HR is running at 120-140 this implies that the Bisoprolol isn't doing its job. What would your HR be without it, do you know? Since there appears to be so many unpleasant side effects associated with Biso can you not discuss trying a different medication? I really apologise if you've already answered these questions; I did read the comments but may have missed it. There's nothing worse than well meaning folks suggesting obvious answers when you've tried everything in the book and then some already.
Don't give up! There is an answer for you out there somewhere. Much love & hugs to you x
I have taken bisoprolol for 5 years. When I went into AF persistently 4 months ago. I was advised to up the dose to 7.5 which lowered the rate from 130 average to 122 average, then to 10 mg per day which lowered it to about 118 average per day - but was miserable to live with.
I did put on weight in this period ( about 2 stones) I was already high with a bmi of 40.
Then the breathing probs started. I made some elderflower champagne, less than 1% alcohol. Drank some and started to swell intestinally every time I had some. Stopped drinking it, but had noticed that when swollen , I couldn’t walk outside and breathe. I realised I had inadvertently made yeast and that the drink was probably still fermenting in my system. Since then whenever my stomach swells through food intolerance or constipation ( that was what happened before the op) I struggle to walk ( I canpootleabout the house no problem ) and breathe - like my diaphragm suddenly goes rigid. I went to hospital when I couldn’t breathe and they watched the change in my breathing when my stomach suddenly deflated and I could walk and talk again. They diagnosed intestinal colic or problems caused by increased bisoprolol. In the bariatric hospital they didn’t have access to my medical records ( that amazed me) and said the breathlessness was AF related above all. My hr was also high because a) they wouldn’t let me take my bisoprolol or flecainide that morning, b) no water since 6 pm the night before c) I was quite anxious. And the hr was only read on a blood pressure monitor - and only once. I would normally feel it if it was that high and I couldn’t. In a morning without food I can walk without a problem, jog for a bit, go up and down the stairs etc. I wonder if it is the bisoprolol.
Have you heard about Dr. William Davis who wrote Wheat Belly and Wheat Belly total Health? There might be some suggestion in there that could help you with weight loss. It helped my husband and myself, just a thought.
I am so sorry to hear what has happened to you. My feeling is that the lack of communication between specialties is contributing to your situation. Surely it is not beyond the bounds of possibility for the consultants to confer with each other then at least your hopes would not be raised prematurely.
You are right Bagrat. I also think that because bariatric surgery is contracted out privately by the nhs, that has caused a lot of problems. When I first moved to Tier 4 about 8 months ago. I told the consultant about fast AF and he said he would write to my EP and I would have the surgery in a special hospital in Manchester attached to a cardiology unit. I became persistent two months later and wrote and told them. I spoke to lots of nurses, had my pre op no problem. Spoke to the general manager last week. They all said - yes we are dealing with this for you. It was a load of crap. The hospital was not a cardiology place at all. The surgical team had not been informed, they only had my info from the pre op - they could see none of my nhs info.I can’t blame them for not operating. They weren’t prepared for me. I dread to think how much that cost the nhs.
Is your AF permanent or paroxysmal.If you were in AF would feel breathless.You must have been in AF prior to operation? You need to speak to the cardiologist
I’m sorry it was canceled on you, but it is up to the surgical team. They are taking the risk as well as you. I am surprised you were cleared. by your heart team. I was supposed to have back surgery a year and a half ago. Along came a fib, and atypical flutter and everything has been shut down by my heart team. I had a pace and ablate in February. Doing great. My doctor was over the moon with my results last month but he told me and no one certain terms that my body needs to heal. I still cannot consider my back surgery until after the first of the year he said that my heart, and I have had enough with the tachycardia I had been suffering with for so long. Anything I have done especially if they are considering use in general anesthesia for me must be cleared by my EP Best of luck going forward. You said that they were concerned about your afib being unstable. It wasn’t about your weight. I have actually dropped close to 50 pounds since February when I got my pacemaker. My entire way of eating has changed not even by choice. I don’t know why. I never had one of my heart doctors pick on me about weight they were concerned, of course, but unless they have a magic wand, they need to take care of you regardless I was scheduled for an ablation within a week of meeting my EP I do hope they sort things out for you. Best of luck again.
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Another cancellation 
Operation cancellations - corona effect and Amiodarone
Ablation cancellation
Woo hoo heart surgery 🫀 
